This is from Ambrose Evans-Pritchard in today’s Telegraph blogs:
“…David Cameron views the NHS as sacrosanct, but that is precisely what must be cut. It is anachronistic that you cannot obtain prescription drugs without going through a doctor — wasting everybody’s time — as if doctors these days reach a better decision in two minutes than well-informed patients with an acute self-interest in getting the matter right. It is precisely this edifice that needs to be hacked down with a machete in a revolutionary rethink about the functions of the state..”
He is right. The Knife works in a big NHS hospital, and knows how the management works. You could save 10% fairly easily without cutting back on much. That’s the view of pretty much all my colleagues, who are fans of the NHS. No-one is thirsting to hoover up the debris in the private sector. Here’s a few:
1. Scrap health boards. What do they really do? Public health issues are national with a few exceptions. GP’s can be contracted centrally as independent practitioners, small groups of hospitals (AKA trusts) can be funded by central government
2. Get tough with GP’s. The government should tell them what they want, not the other way round, and pay less for some of the less valuable services that they offer.
3. Scrap unwieldy clinical governance bureaucracies and devolve the safety/quality issues purely to the specialties
4. Show more flexibility on waiting times targets – the public are not obsessed by the difference between 9 and 12 weeks. Getting these cases done in tight specialties costs a fortune, when you could just wait a little bit longer. this is NOT a return to 1 year waits for a hernia etc..
5. Ban management consultants
6. Get rid of development co-ordinators/advisors etc with clipboards. They are bugger all use.
7. Everyone know some things are bad for you – smoking, booze etc – so stop spending cash telling them this
8. National pricing for drugs and implants, end local negotiations
…..there are lots and lots of these ideas, they just need the will to act on them. Ask any doctor.